At Dermotique, it's about our clients. Always.

We truly value and appreciate your constructive feedback.

Our promise to you is that we will listen and implement changes to improve your experience with us.

Your Name:	*
Your Therapist:	*
Email Address:	*
Date of Visit:	dd 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31mm 01 02 03 04 05 06 07 08 09 10 11 12yyyy 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
How Satisfied are you with your last treatment?:
Would you use/recommend your therapist again?:	Yes No
How would you rate your experience with Dermotique? Please Select. Scale of 1-5 (1=poor job, 5=excellent job)
The team members were friendly & attentive to your needs:	1 2 3 4 5
The team members have good knowledge about products & services:	1 2 3 4 5
Dermotique has a great range of products:	1 2 3 4 5
Dermotique has a great range of services:	1 2 3 4 5
Dermotique is good value for money:	1 2 3 4 5
Dermotique's environment is great to shop in:	1 2 3 4 5
The clinic is clean, tidy & well presented:	1 2 3 4 5
Is there anything that you didn't get from your visit with us that you were looking for?:
Additional comments on how we can improve your satisfaction with us:
	Please tick box if you would like your feedback to be kept anonymous.
	Please tick box if you do not wish your feedback to be used as a testimonial on our website.